Intoeing

What is it?

“Intoeing” (commonly referred to as “pigeon-toe”) describes a condition in which a child’s feet may turn inwards when they walk. It is usually symmetrical and may be associated with tripping or an unusual style of running.

Who gets it?

Intoeing often occurs in early childhood, improving and correcting as the child grows into adolescence.

How does it present?

The condition presents in three possible areas of the leg – the hip, the shinbone (tibia) or the foot.

Hip

Affected children may display more inward turning movement than outward turning movement of their hips. This occurs as a result of the rotation angle of the thigh bone (femur) (femoral anteversion) being higher than usual. As the child grows, the thigh bones also grow and as a result, trotation decreases. This can improve up until the age 12 years in girls.

Shinbone (Tibia)

Referred to as the tibia, the shinbone is the leg bone that sits between the knee and the ankle. When an inward twist occurs, it is known as tibial torsion. This can then lead to intoeing.

Feet (Metatarsus Adductus)

Positioning of the baby in the womb may cause a condition known as a “hooked foot” in which the front part of the food curves inwards. By the age of 4, most children’s feet straighten although some children may require casts or stretches in order to straighten their feet.

What is the natural history?

Given time, most cases of intoeing will correct naturally and treatment (such as night braces, special shoes, stretches, exercises or shoe inserts) is not required. It is, however, recommended that your child avoid any sitting positions as these may encourage the condition.

When should I see an orthopeadic surgeon?

You should consult an orthopaedic surgeon if you notice any of the following:

  • Pain is experienced in the legs
  • The condition affects only one side; or
  • Your child struggles with physical activities, e.g. – cannot run or walk due to trips and falls
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